Presentation
Right sided abdominal pain ?renal colic
Patient Data
Co-existing cholecystitis and right ureteric colic. Findings include pericholecystic fat stranding, right perinephric fat stranding, right hydronephrosis and hydroureter, obstructing stone just proximal to the right vesicoureteric junction, tensile gallbladder fundus sign and Mercedes-Benz sign of air within a gallstone.
Ultrasound confirms acute cholecystitis with gallbladder wall thickening, pericholecystic fluid and an impacted stone within the gallbladder neck. Right hydronephrosis due to the ureteric stone is also seen.
This woman has co-existing acute cholecystitis and ureteric colic. Findings include pericholecystic stranding (blue dotted arrow), perinephric stranding (yellow dotted arrow), hydronephrosis (red dotted arrow), stone just proximal to the right vesicoureteric junction with soft-tissue rim sign (red arrow), tensile gallbladder fundus sign (blue arrows) and Mercedes-Benz sign of air within a gallstone (yellow arrow).
Case Discussion
A rare case of co-existing acute cholecystitis and obstructing ureteric calculus. Some people are just unlucky! This case includes an excellent example of the tensile gallbladder fundus sign of acute cholecystitis and a reasonable example of the Mercedes-Benz sign of air within a gallstone.